Organization Active NPI

Balanced Family Chiropractic LTD

  • Chiropractor
  • Mendota, IL
National Provider Identifier
1972380780
Registry record updated Dec 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BALANCED FAMILY CHIROPRACTIC LTD
Practice address
1301 14TH Ave
Mendota, IL 61342-1001
Phone
(815) 847-8435
NPI assigned
Sep 13, 2023
Last updated
Dec 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Yessenia Torres, DCNPI 1811453632
Title
President
Phone
(815) 538-5075

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1301 14TH Ave
Mendota, IL 61342-1001

Mailing address

2109 Cedar Ave
Mendota, IL 61342-1113
Phone (815) 847-8435

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240105001592 IL Part B Supplier - Clinic/Group Practice 0648621441 Receives reassigned benefits from 1 practitioner
Practice locations: Mendota, IL

National Provider Directory

National Provider Directory

Locations

1301 14th Ave
Mendota, IL 61342
Phone (815) 538-5075

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701475200000",
    "number": "1972380780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 CEDAR AVE",
            "city": "MENDOTA",
            "state": "IL",
            "postal_code": "613421113",
            "telephone_number": "815-847-8435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 14TH AVE",
            "city": "MENDOTA",
            "state": "IL",
            "postal_code": "613421001",
            "telephone_number": "815-847-8435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCED FAMILY CHIROPRACTIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-13",
        "last_updated": "2023-12-02",
        "certification_date": "2023-12-02",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "YESSENIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-538-5075",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mendota, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.